RespiratoryPneumonia II
Patient care
Discharge Teaching
DiagnosticsRisk Factors & Causes
• Prolonged immobility - secretions are not mobilized & get stuck in body • Post-Operative - Anesthesia - the body is put to sleep which traps infection in the lungs
• Elevated WBC - white blood cell count • Over 10,000 • Sputum Culture = Positive • Test tip - cultures are always taken first - BEFORE antibiotics • Think A - Antibiotics A - AFTER cultures, in order to identify the causative bacteria.
Common NCLEX QuestionBest indicator of ventilator associated pneumonia (VAP) ?
Positive sputum culture
Best blood lab value shows effective treatment of pneumonia after IV antibiotics?
White blood Cell count
HESIEncourage 3L of fluid intake per day to promote expectoration
2hrs
>65
1stCULTURES
ELEVATED
8hrs
ISINCENTIVE
SPIROMETER
ISINCREASE SIZE
OF THE ALVEOLI
O2in
CO2out
Over 65 years old #1 - Advanced AGE
1. Reposition side to side Q 2 hours2. Oral Care & Suctioning Q 2 hours
Best indicators of VAP
VAP - “Ventilator AssociatedPneumonia”
positive sputum cultureFeverChest X-ray: new infiltrates
3. Chlorhexidine
NCLEX TIP
Mobilize secretions & Expand Lungs
Chest physiotherapy
Huff coughing technique
HOB UP! High Fowler’s
AVOID cough suppressants
Positioning
TCDB - turn cough & deep breath!
Fluid 2 - 3 L per day
Hypoxia in Unilateral Pneumonia?= Good Lung Down
NCLEX TIP
NCLEX TIP
Early ambulation
Chlorhexidine swab
Hand Washing Mouth Care Q 12 hour
Incentive Spirometer Q Hour GIVE Pain Meds
(within 8 hours after surgery) Cough with splinti
Common Exam Questions
Mobilize Secretions
Re-expand Alveoli
Antitussives: CodeineCool mist humidifier at night Increase Fluid
Avoid cough suppressants
IS - Incentive spirometer at home
Prevent Reinfection
FeverConfusion SOB, cough, sputum
Finish oral antibiotics at home Pneumonia vaccine (Every 5 years) Smoking cessation Hand Washing Schedule follow up & Chest X-ray Report: increased or Worsening
Top Related